The Cigna Group primarily delivers pharmacy benefit management (PBM) and health insurance services. Its PBM and specialty pharmacy capabilities, significantly expanded through the 2018 merger with Express Scripts, are mainly marketed to health plans and employers. The company’s largest PBM contract is with the Department of Defense, and it recently secured a multiyear agreement with leading insurer Centene. In health insurance and related benefits, Cigna mainly serves employers through self-funded arrangements. The company operates predominantly in the United States, covering 16 million U.S. medical members and 2 million international medical members as of December 2025.